DTAA Declaration NRI With Tax Residency Certificate

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DTAA DECLARATION

(Valid only if accompanied with Tax Residency Certificate)


To,
HDFC Limited
India

I, ____________________________________________ _______________son/daughter/wife of
_________________________________________aged _________ years, presently residing at
____________________________________________________________________ (Complete address) do
hereby solemnly declare and affirm on oath as follows:

1. I am a resident/domiciled in ____________ as referred to under Article 4 of the Double Taxation


Avoidance Agreement entered into between India and ___________which is my country of tax residence
and I do not have any permanent establishment in India as per DTAA entered. I am attaching my Tax
Residency Certificate (TRC) herewith in support of this declaration.
2. I am not a resident of India in terms of the Treaty for the financial year _____________.
3. I am the beneficial owner of the investments made by me in India/ income receivable by me from
such investments in India.
4. The amount receivable is towards interest and falls under the head “Interest” under Article _____ of
the Treaty.
5. The place of assessment of my world income is______________.
6. I undertake to promptly inform the HDFC Ltd. in writing should there be any change in facts given
above, including but not limited to change in tax residential status, nature of holding of income, etc.
7. I grant irrevocable exclusive right to HDFC Ltd. to recover the tax and other charges arising on
account of change in facts mentioned in point 6/change in tax laws or interpretations thereof from any
amounts due to me, or, otherwise, at the discretion of HDFC Ltd. I undertake to pay on demand by
HDFC Ltd. any shortfall between the amounts recovered by HDFC Ltd. and the amount payable by me
and indemnify and hold HDFC Ltd. harmless from any loss on account of the change of facts.
8. In the event there is any income tax demand (including interest, charges or levies) raised in India in
respect of these amounts we undertake to pay the demand forthwith and indemnify and hold HDFC
Ltd. harmless from any income tax demand (including interest, penalty, charges or levies) raised in India
on the HDFC Ltd. on account of any misstatement / misrepresentation/ errors of omission or
commission by me or any other person, and provide HDFC Ltd. with all information/documents that
may be necessary for any proceedings before Income-tax / Appellate Authorities in India.
9. I also undertake to provide, if applicable, a fresh tax declaration to the HDFC Ltd. for every financial
year, before the first interest due date for deposit placed with HDFC Ltd. I confirm that my delay or
failure to provide such fresh tax declaration will allow the HDFC Ltd. to apply the income tax rate
provided in the Indian Income-tax Act, 1961 ignoring the lower rates in the tax treaty. My claim, if any,
for refund of excess Indian income tax, if any, will lie directly against the Indian income tax department,
Ministry of Finance, Government of India and the HDFC Ltd. will not be liable for the same in any
manner.

I confirm that, I have read and understood the provisions of the Double Taxation Avoidance Agreement
between India and ________(country of residence) including the Articles 1, 2, 4 and _____(Article on
Interest) of the Treaty, copy of which has been made available to me.

I, ________________ (name and address), hereby declare that the contents above are correct, complete
and truly stated.

Signature :

Name : Customer ID :

PAN : __ (Indian Income Tax Permanent Account Number)

Place : Date :

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